<div class="widget">
    <div class="widget-body">
            <form class="am-form tpl-form-line-form" data-am-validator id="formDoSubmitDialog">
              <input type="hidden" name="Id" id="Id" value="{{.m.Id}}">
              <div class="am-form-group">
                  <label class="am-u-sm-3 am-form-label">门店名称：</label>
                  <div class="am-u-sm-9">
                    <input name="Name" type="text" id="Name"  placeholder="长度不超过40" maxlength="40" value="{{.m.Name}}" required/>
                  </div>
              </div>
              <div class="am-form-group">
                    <label class="am-u-sm-3 am-form-label">门店全名：</label>
                    <div class="am-u-sm-9">
                        <input name="FullName" type="text" id="FullName"  placeholder="全名用于打印单据抬头" maxlength="40" value="{{.m.FullName}}" />
                    </div>
              </div>
                <div class="am-form-group">
                    <label class="am-u-sm-3 am-form-label">联系电话：</label>
                    <div class="am-u-sm-9">
                        <input name="Telephone" type="text" id="Telephone"  placeholder="门店联系电话" maxlength="40" value="{{.m.Telephone}}" required/>
                    </div>
                </div>
                <div class="am-form-group">
                    <label class="am-u-sm-3 am-form-label">联系地址：</label>
                    <div class="am-u-sm-9">
                        <input name="Address" type="text" id="Address"  placeholder="门店联系地址" maxlength="60" value="{{.m.Address}}" required/>
                    </div>
                </div>

                <div class="am-form-group">
                    <label class="am-u-sm-3 am-form-label">负责人：</label>
                    <div class="am-u-sm-9">
                        <input name="Shopowner" type="text" id="Shopowner"  placeholder="负责人姓名" maxlength="60" value="{{.m.Shopowner}}" required/>
                    </div>
                </div>
                <div class="am-form-group">
                    <label class="am-u-sm-3 am-form-label">负责人电话：</label>
                    <div class="am-u-sm-9">
                        <input name="ShopownerTel" type="text" id="ShopownerTel"  placeholder="负责人电话" maxlength="60" value="{{.m.ShopownerTel}}" required/>
                    </div>
                </div>

              <div class="am-form-group">
                  <label class="am-u-sm-3 am-form-label">备注：</label>
                  <div class="am-u-sm-9">
                    <textarea id="Remarks" name="Remarks" maxlength="500">{{.m.Remarks}}</textarea>
                  </div>
              </div>


             <div class="am-form-group">
                  <label class="am-u-sm-3 am-form-label"></label>
                  <div class="am-u-sm-9">
                    <button class="am-btn am-btn-secondary" type="submit">确认提交</button>
                    <button class="am-btn am-btn-default" type="reset">重置</button>
                  </div>
              </div>
            </form>
    </div>
</div>